Kitamura Tatsuru, Tanimoto Chie, Oe Shingo, Kitamura Maki, Hino Shoryoku
Department of Neuropsychiatry, Ishikawa Prefectural Takamatsu Hospital, Kahoku, Japan.
Department of Nursing, Ishikawa Prefectural Nursing University, Kahoku, Japan.
Psychogeriatrics. 2019 Jan;19(1):3-9. doi: 10.1111/psyg.12352. Epub 2018 Jul 30.
The Japanese Comprehensive Strategy to Accelerate Dementia Measures, known as the New Orange Plan, aims to support people with dementia living in their communities. Home-visit nurses (HVN) are expected to play an important role in this comprehensive support system. In this preliminary study, we explored caregivers' experiences before and after implementation of HVN care for persons with dementia who lived alone.
This study was a qualitative descriptive design using in-depth interviews with five family caregivers of persons with dementia who lived alone while receiving HVN. Thematic content analysis was undertaken.
Before receiving HVN, caregivers experienced anxiety and embarrassment due to the occurrence of dementia symptoms, and they also experienced considerable isolation and anguish after hearing the diagnosis. After initiating HVN, caregivers gained a feeling of security and an alleviation of psychological stress. They also gained a deeper understanding of the disease and appropriate care for dementia patients. Notably, caregivers perceived not only positive changes in themselves, but also in the recipients, such as improvements in symptoms and quality of life. Finally, caregivers realized that people with dementia can live alone if appropriate services are provided.
HVN can have a positive impact on family caregivers involved in dementia care, as well as on the recipients' psychological status. Overall, the experience of HVN made the family caregivers more positive about home care for their family member with dementia. Although further case studies are needed to make definitive conclusions, we believe that HVN could play a key role in the forthcoming New Orange Plan.
日本加速痴呆症应对综合战略，即新橙色计划，旨在支持居住在社区中的痴呆症患者。家访护士（HVN）有望在这一综合支持系统中发挥重要作用。在这项初步研究中，我们探讨了对独居痴呆症患者实施家访护理前后照顾者的经历。
本研究采用定性描述性设计，对五名在接受家访护理时独居的痴呆症患者的家庭照顾者进行了深入访谈，并进行了主题内容分析。
在接受家访护理之前，照顾者因痴呆症状的出现而感到焦虑和尴尬，在听到诊断结果后，他们还经历了相当程度的孤立和痛苦。开始接受家访护理后，照顾者获得了安全感，心理压力得到缓解。他们对疾病也有了更深入的了解，以及对痴呆症患者的适当护理。值得注意的是，照顾者不仅感受到了自身的积极变化，也看到了接受护理者的积极变化，如症状改善和生活质量提高。最后，照顾者意识到，如果提供适当的服务，痴呆症患者可以独居。
家访护理对参与痴呆症护理的家庭照顾者以及接受护理者的心理状态都能产生积极影响。总体而言，家访护理的经历让家庭照顾者对为患有痴呆症的家庭成员提供居家护理更加积极。尽管需要进一步的案例研究才能得出明确结论，但我们认为家访护理可能在即将出台的新橙色计划中发挥关键作用。
